This Is Going To Hurt shows a broken NHS not misogyny

NOT ordinarily one for memoirs, I put my copy of Adam Kay’s This Is Going To Hurt on my bookshelf and forgot about it for a while.

It was a gift, and I should have trusted the friend who gave it to me to know my own mind better than I do.

After hearing folk rave about it, I picked it up and I didn’t put it down. It was a hilarious, eye-popping romp through an NHS labour ward. It took you to A&E and gave a peek behind the curtains – literally – at humanity when at its most vulnerable and ridiculous.

The book is riotously, make-you-breathless funny, but it is also laced with pathos and the looming feeling that something is going to go horribly awry. You know, in the book, that Adam Kay leaves medicine and you’re waiting for the final circumstance that tips him over and out of the health service.

So I was pleased to learn This Is Going To Hurt was to be made into a BBC series. Marvellous. Just the tonic for the dark and drizzly spell that leads us out of winter and into the better days of spring.

Well, I got that wrong.

The TV version is far less funny – largely because the fourth-wall-breaking asides to camera are more sardonic and sarcastic than amusing, but mainly because the plotting is very different.

What was surprising, though, was the backlash. Concerns were raised that This Is Going To Hurt is misogynist. The complaint ran that the show’s female patients were nothing more than cyphers, the narrative focus on Dr Kay and not on the women he was treating.

This interpretation didn’t speak to the actual content of the programme. It’s a memoir written by a male doctor – of course it’s going to focus on the protagonist and not on his patients.

More than that, though, the show is about the failings of the system, of the NHS as a vast machine that chews up and spits out nigh-on everyone involved. It might be suboptimal for the women but it is just as brutal for the medical staff.

This week I’ve noticed think pieces lightly hooked on This Is Going To Hurt that unquestionably take the line that Adam Kay himself is a misogynist, as well as online chatter that does the same.

Yes, This Is Going To Hurt is a memoir but the TV series is a fictionalised version of that memoir. It’s the difference between surmising a view of Eva Perón directly from her diaries and from Evita. You can’t possibly surmise that Adam Kay hates women based on a BBC drama loosely pegged on his life.

At Christmas I tweeted my disgruntlement with the John Lewis advert, an exercise in perpetuating tired gender stereotypes. In the many nippy responses to that tweet, one of the common themes was “For God sake, it’s just an advert.”

Well, I thought, wait til I tell them about my English Literature degree. But that’s the thing with critical analysis – you can interpret material, fair enough, but to interpret someone’s character from a fictional show about them is a lit crit too far.

I cover court every second week for our sister title, The Glasgow Times, and there are moments where the court officer and I have to avoid eye contact because I’m corpsing so badly at something an accused has been quoted as saying or perhaps the surreal mitigation put up by a defence solicitor.

There’s nothing quite so discombobulating as a particularly well-spoken depute fiscal saying the c-word umpteen times during a narrative and having the even plummier sheriff repeat the word back.

Despite appallingly inappropriate fits of the giggles, I find court reporting, down in the basement of Glasgow Sheriff Court, just really, really sad. It is a carousel of people who are struggling with addictions or poverty or the effects of abuse or all three and more. Mitigation is routinely that the accused was drunk or high and doesn’t remember the offence.

There are careers – the law, policing, medicine, social work – where life is spent staring at the worst, most brutal aspects. Yet even the bleakest circumstances can be cut with absurdity and even the most compassionate human might find solace in humour.

Light joking and silly acronyms go a long way in blunting the stabbing edges of life on the front line. There is a limit to that and a fine line between relief and cruelty but when the Adam Kay character refers to, say, obs and gynae as “Twats and Brats” it’s not misogyny, it’s just a form of gallows humour.

It might seem crass to outsiders but it’s a survival mechanism.

To overlook that, and to focus instead on the sketchily drawn patients, is to miss the point of the show.

If the TV series is representative of a political time and culture, then the backlash against the TV series must also be set in a context.

We are in a climate where women are, despite long, long protests, still ignored and misunderstood by the medical profession, their female complaints belittled. In some quarters, and this is by no means universal, but still important, women feel that their bodily reality is being, if not erased, then undermined.

So you can understand the automatic response is to bristle at seeing labouring women portrayed in the way they are.

I’m an NHS frequent flier and, like everyone who spends any length of time in hospital, you have your good stories and your bad. It’s usually the negative stories that stick in your mind.

I’ve never given birth, but I have had gynaecological outpatient treatment – a cervical biopsy, among many other fun times.

The consultant who performed it had zero bedside manner to speak of and the chaperoning nurse was little better. The procedure wasn’t explained to me and I didn’t know what was happening.

One moment I was reclining in the stirrups, the next moment I was told to cough and there was a searing, unexpected pain.

I didn’t want to make a fuss, that good old female social conditioning kicking in, so I made a joke about the lot of women. The nurse immediately put me in place, telling me that men had it tough too and I ought to see what happens on a urology ward. I felt chastened, belittled and not a little violated.

As it happened, I also had a fair insight into what happens on a urology ward, given decades of kidney problems. For a long time I saw my consultant every six months. One in particular stays with me because she would give me as little as two or three minutes for my appointment and would stand at the door of the consulting room with her hand on the handle while I asked questions.

Every appointment was a dreaded event.

This Is Going To Hurt gives some insight into the pressures on that nurse and those consultants. Perhaps they didn’t lack empathy, perhaps they were just too stressed, too pressured and too overwhelmed to really see me as person. Clearly I was too myopic to see them as people.

I’m not saying it’s right. I’m saying I understand it more, and that understanding is helpful.

This Is Going To Hurt is not a programme about the patients, it is a damning indictment of a broken system and how an institution can break the people within it. To miss that is to overlook the humanity of the NHS staff the drama foregrounds.

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